[AGENCY LETTERHEAD]

OCULAR INSPECTION
SUMMARY
(This shall be attached to the Inspection Report)

I. CASE DETAILS
A. Case No.
B. Case Title
C. Case Subject
(For Demolition,
Violation of P.D. 1096,
Revocation of Permits,
etc.)
II. INSPECTION DETAILS
A. Date
B. Time
C. Location
D. Building/Structure
Description

III. ATTENDANCE
A. NBCDO Inspectorate
Team
Name Position Office Signature
1.
2.
3.
4.
5.
B. Office of the Building
Official/Engineering Unit
1.
2.
C. Appellant(s)
1.
2.
3.
4.
D. Appellee(s)*
1.
2.
3.
4.
*Please indicate if not present and reason for absence/non-participation

NOTED BY:

[HEAD OF OFFICE]